A new grant from Fogarty International Center will support SIG's Alissa Davis as she, along with Gaukhar Mergenova and Carrigan L. Parish, develops a sustainable care improvement intervention for dental providers in Kazakhstan.
Kazakhstan has one of the world's fastest growing HIV epidemics, primarily driven by substance use. HIV-related oral conditions adversely impact the health and medication adherence of people with HIV, problems that are worsened for people who also use drugs. Oral health problems and unmet dental needs are common among people with HIV and who use drugs. Although dentists are responsible for treating the many oral consequences of HIV and substance use, they report minimal, if any, training and knowledge in HIV and patient substance use. Yet their professional role has evolved to include some primary care, such as chairside medical screenings, such as screening for HIV medication adherence and substance use disorder (SUD).
While current research establishes negative attitudes toward people with HIV and who use drugs, especially for those with co-occurring conditions, research on care improvement interventions for dental providers has largely been absent. In this study, the research team aims to address this gap. They will identify drivers and manifestations of negative attitudes toward people with HIV, people who use drugs, and individuals with co-occurring conditions among dental providers. Based on this information, they will develop an intervention that will increase screening for HIV medication adherence and SUD by dental providers and conduct a cluster-randomized controlled trial assessing intervention feasibility, acceptability, and preliminary impact on dental providers' negative attitudes. The study will advance methodologies that more objectively assess negative attitudes among providers and examine differences in having one stigmatized health condition versus two.
For this study, Dr. Davis and the SIG research team will work in collaborationg with the Asfendiyarov Kazakh National Medical University, the Kazakhstan Ministry of Health, the United Kazakhstan Association of Dentists, and the Weill Cornell Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV (CHERISH).